Evaluation of laparoscopic knot training in a silicone model.

INTRODUCTION: in videolaparoscopic surgery, movements are conducted from a twenty times magnified image of an indirect operative field. The video interface used assumes the need for depth perception using two dimensions instead of three. OBJECTIVE: to evaluate the effectiveness of training to perform the laparoscopic knot in a silicone model, in 8-hour courses, and to analyze the correlation of learning outcomes with factors such as: sex, age, laterality, previous knowledge in endosuture and medical specialty. MATERIAL AND METHODS: in this prospective and randomized study, 56 students were evaluated, who took 8-hour courses, with groups of up to ten students. We used: a white box with camera, LCD screen and silicone piece. Four exercises were performed on the silicone mold: right hand, left hand, needle at 45° and back hand. RESULTS: 56 students (mean age = 33.28 years). The female group, n=18, mean age 29.61 years, 17 right-handed and 1 left-handed. The male group, n=38, mean age 34.57 years, 35 right-handers, 1 left-handed and 2 ambidextrous. In both groups, no correlation was observed between the analyzes of well performed knots when correlated with the age or sex of the participants. CONCLUSION: laparoscopic knot training, in silicone molds, in 8 h courses, proved to be effective. Factors such as gender, age, laterality, previous knowledge in endosuture and medical specialty do not interfere with the learning results.

Evaluation of laparoscopic knot training in a silicone model / Avaliação do treinamento de sutura laparoscópica em modelo de silicone

ABSTRACT Introduction: in videolaparoscopic surgery, movements are conducted from a twenty times magnified image of an indirect operative field. The video interface used assumes the need for depth perception using two dimensions instead of three. Objective: to evaluate the effectiveness of training to perform the laparoscopic knot in a silicone model, in 8-hour courses, and to analyze the correlation of learning outcomes with factors such as: sex, age, laterality, previous knowledge in endosuture and medical specialty. Material and Methods: in this prospective and randomized study, 56 students were evaluated, who took 8-hour courses, with groups of up to ten students. We used: a white box with camera, LCD screen and silicone piece. Four exercises were performed on the silicone mold: right hand, left hand, needle at 45° and back hand. Results: 56 students (mean age = 33.28 years). The female group, n=18, mean age 29.61 years, 17 right-handed and 1 left-handed. The male group, n=38, mean age 34.57 years, 35 right-handers, 1 left-handed and 2 ambidextrous. In both groups, no correlation was observed between the analyzes of well performed knots when correlated with the age or sex of the participants. Conclusion: laparoscopic knot training, in silicone molds, in 8 h courses, proved to be effective. Factors such as gender, age, laterality, previous knowledge in endosuture and medical specialty do not interfere with the learning results.

RESUMO Introdução: na cirurgia videolaparoscópica os movimentos são conduzidos a partir de uma imagem magnificada de vinte vezes de um campo operatório indireto. A interface de vídeo utilizada pressupõe a necessidade de percepção de profundidade utilizando duas dimensões ao invés de três. Objetivo: avaliar a eficácia do treinamento de execução do nó laparoscópico em modelo de silicone, em cursos de 8h, e analisar a correlação dos resultados de aprendizagem com fatores como: sexo, idade, lateralidade, conhecimentos prévios em endosutura e especialidade médica. Material e Métodos: Neste estudo, prospectivo e randomizado, foram avaliados 56 alunos, que realizaram cursos de 8h de duração, com turmas de até dez alunos. Foram utilizados: uma caixa branca com câmera, tela de LCD e peça de silicone. No molde de silicone foram executados quatro exercícios: mão direita, mão esquerda, agulha a 45° e back hand. Resultados: 56 alunos (média de idade = 33,28 anos). O grupo feminino, n=18, média de idade 29,61 anos, 17 destras e 1 canhota. O grupo masculino, n=38, média de idade 34,57 anos, 35 destros, 1 canhoto e 2 ambidestros. Em ambos grupos não foram observados nenhuma correlação entre as análises de nós bem executados quando correlacionados com a idade ou sexo dos participantes. Conclusão: o treinamento de nó laparoscópico, em moldes de silicone, em cursos de 8h de duração, mostrou-se eficaz. Fatores como sexo, idade, lateralidade, conhecimentos prévios em endosutura e especialidade médica, não interferem nos resultados do aprendizado.

Study of Penis Structure and Development in Fetus With Prune Belly Syndrome.

OBJECTIVE: To evaluate the influence of prune belly syndrome (PBS) on the development of penises in human fetuses. METHODS: We studied 39 human fetuses (including 4 with PBS) aged 11-22 weeks post conception. We measured the length and width of the free portion and penis root and the penis total length (PTL). In 21 fetuses of the control group and in 3 with PBS we analyze the penile with histochemical and immunohistochemical methods. The total penile area, area of corpora cavernosa, area of corpus spongiosum, and thickness of tunica albuginea were measured by stereological method. Means were compared using the Kolmogorov-Smirnov and ANOVA test (P <.05). RESULTS: We did not observe difference in PTL (P = .999) when we compared the control group (4.69-29.77 mm, mean = 16.2 mm; SD = 6.34 mm) with the PBS (12.23-23 mm, mean = 16.16; SD = 4.99). The total penile area (P = .002), the area of corpora cavernosa (P = .023) and the area of corpus spongiosum (P = .004) had a significant increase when comparing the PBS with the control group. CONCLUSION: In fetuses with PBS there is no change in the length of the penis but we observed a low rate of growth in all the other histologic parameters analyzed, suggesting that PBS impacts the penile development.

Expression of stromal elements of prostatic adenocarcinoma in different gleason scores.

PURPOSE: To quantify and compare the expression of stromal elements in prostate adenocarcinoma of different Gleason scores with non-tumor area (control). METHODS: We obtained 132 specimens from samples of prostate peripheral and transition zone. We analyzed the following elements of the extracellular matrix: collagen fibers, elastic system, smooth muscle fibers and blood vessels. The tumor area and non-tumor area (control) of the TMA (tissue microarray) were photographed and analyzed using the ImageJ software. RESULTS: The comparison between the tumor area and the non-tumor area showed significant differences between stromal prostate elements. There was an increase of collagen fibers in the tumor area, mainly in Gleason 7. Elastic system fibers showed similar result, also from the Gleason 7. Blood vessels showed a significant increase occurred in all analyzed groups. The muscle fibers exhibited a different behavior, with a decrease in relation to the tumor area. CONCLUSIONS: There is a significant difference between the extracellular matrix in prostate cancer compared to the non-tumor area (control) especially in Gleason 7. Important modifications of the prostatic stromal elements strongly correlate with different Gleason scores and can contribute to predict the pathological staging of prostate cancer.

Expression of stromal elements of prostatic adenocarcinoma in different gleason scores

Abstract Purpose: To quantify and compare the expression of stromal elements in prostate adenocarcinoma of different Gleason scores with non-tumor area (control). Methods: We obtained 132 specimens from samples of prostate peripheral and transition zone. We analyzed the following elements of the extracellular matrix: collagen fibers, elastic system, smooth muscle fibers and blood vessels. The tumor area and non-tumor area (control) of the TMA (tissue microarray) were photographed and analyzed using the ImageJ software. Results: The comparison between the tumor area and the non-tumor area showed significant differences between stromal prostate elements. There was an increase of collagen fibers in the tumor area, mainly in Gleason 7. Elastic system fibers showed similar result, also from the Gleason 7. Blood vessels showed a significant increase occurred in all analyzed groups. The muscle fibers exhibited a different behavior, with a decrease in relation to the tumor area. Conclusions: There is a significant difference between the extracellular matrix in prostate cancer compared to the non-tumor area (control) especially in Gleason 7. Important modifications of the prostatic stromal elements strongly correlate with different Gleason scores and can contribute to predict the pathological staging of prostate cancer.

Effect of a high-fat diet on the rat bladder wall and bioactive action of Brazil nut oil

ABSTRACT High-fat diet-induced obesity is associated with metabolic disorders. The Brazil nut has bioactive substances and has been used to control the damage caused by obesity in several organs. The work intended to show the damage caused by high-fat diet in the bladder wall and if the Brazil nut oil added to the diet could ameliorate or reverse this effect. Sixty-day-old rats were divided into two groups: C (control, n = 30) and HF (high-fat, n = 30) diets. At 90 days, 10 animals of each group were sacrificed. The others were divided into 4 groups: C and HF (animals that maintained their previous diet, n = 10 for each group) and C / Bno and HF / Bno (animals whose control or high-fat diet was supplemented by Brazil nut oil, n = 10 for each group). Sacrifice occurred at 120 days, and the bladders were removed and analyzed. Epithelial height was increased in the HF compared to the C group. In contrast, the C / Bno had a lower epithelial height compared to the others. The percentage of collagen between the detrusor muscle fibers was significantly greater in C / Bno, HF and HF / Bno than in control group. The HF had a larger muscle fiber diameter than the C group, while the C / Bno presented lower values than the HF and HF / Bno groups. HF diets induced bladder wall damage. These changes in the rat's bladder wall were partially reversed by the Bno.

Effect of a high-fat diet on the rat bladder wall and bioactive action of Brazil nut oil.

High-fat diet-induced obesity is associated with metabolic disorders. The Brazil nut has bioactive substances and has been used to control the damage caused by obesity in several organs. The work intended to show the damage caused by high-fat diet in the bladder wall and if the Brazil nut oil added to the diet could ameliorate or reverse this effect. Sixty-day-old rats were divided into two groups: C (control, n = 30) and HF (high-fat, n = 30) diets. At 90 days, 10 animals of each group were sacrificed. The others were divided into 4 groups: C and HF (animals that maintained their previous diet, n = 10 for each group) and C / Bno and HF / Bno (animals whose control or high-fat diet was supplemented by Brazil nut oil, n = 10 for each group). Sacrifice occurred at 120 days, and the bladders were removed and analyzed. Epithelial height was increased in the HF compared to the C group. In contrast, the C / Bno had a lower epithelial height compared to the others. The percentage of collagen between the detrusor muscle fibers was significantly greater in C / Bno, HF and HF / Bno than in control group. The HF had a larger muscle fiber diameter than the C group, while the C / Bno presented lower values than the HF and HF / Bno groups. HF diets induced bladder wall damage. These changes in the rat's bladder wall were partially reversed by the Bno.

Structural changes of dilated pelvic ureters in adults.

PURPOSE: To perform a quantitative assessment of different types of pelvic ureter tissues with chronic dilation in adults, using stereological methods. METHODS: We analyzed fragments of dilated pelvic ureters obtained from 6 patients aged between 35 and 67 years (mean, 46 years) who underwent ureteral reimplantation surgery for different reasons. The obstruction duration ranged from 27 to 180 days (mean, 93 days). The control group included fragments of normal pelvic ureters obtained during nephrectomy in 7 kidney transplant donors (age: range, 25-51 years; mean, 36 years). The volumetric density of collagen in the ureter, elastic fibers, and smooth muscle fibers was assessed. RESULTS: The volumetric density (Vv) of collagen showed no significant difference between the two groups (control: 45.3 ± 6.1; dilated: 40.8 ± 6.9; P = 0.23). A statistically significant increase in Vv of elastic fibers was observed in the dilated ureters (control: 18.4 ± 1.2; dilated: 24.6 ± 5.4; P = 0.03). A statistically significant increase in the Vv of smooth muscle fibers was observed in the dilated ureter (control: 42.0 ± 6.0; dilated: 56.2 ± 6.1; P = 0.001). CONCLUSION: The chronically dilated pelvic ureters had significantly more elastin and smooth muscle contents than the controls.

Structural changes of dilated pelvic ureters in adults

PURPOSE: To perform a quantitative assessment of different types of pelvic ureter tissues with chronic dilation in adults, using stereological methods. METHODS: We analyzed fragments of dilated pelvic ureters obtained from 6 patients aged between 35 and 67 years (mean, 46 years) who underwent ureteral reimplantation surgery for different reasons. The obstruction duration ranged from 27 to 180 days (mean, 93 days). The control group included fragments of normal pelvic ureters obtained during nephrectomy in 7 kidney transplant donors (age: range, 25-51 years; mean, 36 years). The volumetric density of collagen in the ureter, elastic fibers, and smooth muscle fibers was assessed. RESULTS: The volumetric density (Vv) of collagen showed no significant difference between the two groups (control: 45.3 ± 6.1; dilated: 40.8 ± 6.9; P = 0.23). A statistically significant increase in Vv of elastic fibers was observed in the dilated ureters (control: 18.4 ± 1.2; dilated: 24.6 ± 5.4; P = 0.03). A statistically significant increase in the Vv of smooth muscle fibers was observed in the dilated ureter (control: 42.0 ± 6.0; dilated: 56.2 ± 6.1; P = 0.001). CONCLUSION: The chronically dilated pelvic ureters had significantly more elastin and smooth muscle contents than the controls. .

Desenvolvimento do pênis durante o período fetal humano (13 a 36 semanas pós-concepção) / Penile development during the fetal period in humans (13 to 36 weeks post conception)

Objetivo: Analisar, em fetos humanos, o crescimento da área do pênis, da túnica albugínea e das estruturas eréteis (corpos cavernosos e corpo esponjoso), bem como o aparecimento e modificações das principais estruturas que compõem estes tecidos (colágeno, músculo liso e fibra elástica) durante o período fetal (13 a 36 semanas pós-concepção), fornecendo padrões normativos de crescimento. Material e Métodos: Foram utilizados 56 fetos humanos do sexo masculino com idade gestacional compreendida entre 13 e 36 semanas pós-concepção (SPC). Foram utilizadas técnicas histoquímicas, imunohistoquímicas, e análises morfométricas, e analisados os seguintes parâmetros: área total do pênis, área do corpo cavernoso, área do corpo esponjoso e a espessura da túnica albugínea na região dorsal e ventral do corpo cavernoso. No corpo cavernoso e no corpo esponjoso, as fibras musculares, o colágeno e as fibras do sistema elástico, foram identificados e quantificados por percentagem, no programa Image J (NIH, Bethesda, EUA).Resultados: Da 13ª à 36ª semana pós-concepção, a área do pênis variou de 0,95mm2 a 24,25mm2. No mesmo período a área do corpo cavernoso variou de 0,28mm2 a 9,12mm2 e a área do corpo esponjoso de 0,14mm2 a 3,99mm2. No corpo cavernoso a percentagem de fibras colágenas, fibras musculares e fibras do sistema elástico variaram, respectivamente, de 19,88% a 36,60%, de 4,39 % a 29,76 % e de 1,91% a 8,92%. No corpo esponjoso a percentagem de fibras colágenas, fibras musculares e fibras do sistema elástico variaram, respectivamente de 34,65% a 45,89%, de 0,60% a 11,90% e de 3,22% a 11,93%. A espessura da túnica albugínea variou de 0,029 a 0,296 na região dorsal e de 0,014 a 0,113 na região ventral do corpo cavernoso.Conclusão: Existe correlação fortemente positiva entre o crescimento da área total, da área do corpo cavernoso e da área do corpo esponjoso, com a idade gestacional, assim como existe correlação entre o crescimento dos elementos constituintes do tecido...

Objective: To analyze the development of penile area, tunica albuginea thickness and the main components of the erectile tissue, such as collagen, smooth muscle and elastic system fibers, in human fetuses, in order to provide normative parameters of development. Material and Methods: We studied 56 male human fetuses aged 13 to 36 weeks postconception (WPC). We used histochemical, immunohistochemical and morphometric techniques to analyze the following parameters: total penile area, area of the corpora cavernosa, area of the corpus spongiosum and thickness of tunica albuginea in the dorsal and ventral region. In the corpora cavernosa and in the corpus spongiosum, the collagen, smooth muscle fibers and elastic system fibers were identified and quantified as percentage by using the Image J software (NIH, Bethesda, USA).Results: From 13 to 36 WPC, the area of the penis varied from 0.95 mm2 to 24.25 mm2. Also, the area of the corpora cavernosa varied from 0.28 mm2 to 9.12 mm2 and the area of the corpus spongiosum from 0.14 mm2 to 3.99 mm2. In the corpora cavernosa, the amount of collagen, smooth muscle fibers and elastic system fibers varied from 19.88% to 36.60%, from 4.39 % to 29.76 % and from 1.91% to 8.92%, respectively. In the corpus spongiosum, the amount of collagen, smooth muscle fibers and elastic system fibers varied from 34.65% to 45.89%, from 0.60% to 11.90% and from 3.22% to 11.93%, respectively. The thickness of the tunica albuginea varied from 0.029 to 0.296 in the dorsal region and from 0.014 to 0.113 in the ventral region of the corpora cavernosa. Conclusion: We found strong correlation between the total area, the corpora cavernosa and the corpus spongiosum penile area, with the fetal age in WPC, as well as between collagen, smooth muscle and elastic fibers with fetal age in WPC. The growth rate was more intense during the 2nd trimester (13 to 24 WPC) of gestation when compared to the 3rd trimester (25 to 36 WPC). The thickness of the tunica...